Asbestos, Smoking and the art of Illusion (1)
(Which of these is really responsible for most 'smoke related' diseases?)
The Magicians Oath
As a magician I promise never to reveal the secret of any illusion to a non-magician, unless that one swears to uphold the Magician's Oath in turn. I promise never to perform any illusion for any non-magician without first practicing the effect until I can perform it well enough to maintain the illusion of magic."
The greatest ever mass deception?
Speaking at a central London conference on 6th November 2008, organised by Health Secretary Alan Johnson, Gordon Brown said some people would argue that the current period of global financial turbulence should mean ambitious plans are postponed. "I believe there can be no worse time than this to turn back," he said. “Health is now indisputably a global issue and more needs to be done on expanding the international knowledge base on the social factors determining how healthy people's lives are”. (09) It was no coincidence that this statement was made at that time. Over the previous few days, weeks and months it had become increasingly clear that the smoking ban had and was causing phenomenal damage to society, business and jobs. Strong rumours came to light that many back bench Labour MPs were becoming increasingly unhappy at this state of affairs and there was growing support for a relaxation of the restrictions on smokers to try to stem pub and club closures and other economic damage. Brown’s statement of intent would appear to be a strong, albeit veiled, put-down of those MPs, whilst making it clear that the smoking ban and all other state interventions into lifestyle choices and ‘health inequalities’ would continue unchanged, regardless as to what damage would be caused to all other aspects of society. As little has been said on the subject by MPs since, it would appear that they have in fact ’toed the line’.
The most important part of this statement was not the veiled rebuke to rebel MPs but the emphasis on ‘social factors’ as being the main aspect of ‘health inequalities’. Reading into this, it is clear that Brown considers personal lifestyle choices as more important to health than external factors such environmental and industrial pollution. Why this overriding emphasis on ‘social factors’ when there has been ample evidence that ‘environmental factors’ and ‘industrial factors’ etc. have had a major detrimental effect on global health?
Brown cannot claim this point of view as his own, he is merely a puppet, ‘toeing the line’ of the World Health Organization’s (WHO) ‘Framework Convention on Tobacco Control’.(10) The WHO in turn are merely ‘toeing the line’ of the Pharmaceutical industry (they prefer to call it a ‘partnership’) (11) Brown’s own advisers consist almost entirely of proponents of anti-tobacco. The majority, if not all, are in some way funded, supported by, connected to, or represent Big Pharma and/or anti tobacco, examples are SCOTH, and The Royal College of Physicians (founder of ASH) whose entire public health priorities apparently consists of alcohol control, tobacco control and climate change. Factors external to the individual such as industrial pollution are not even considered! (12)
This all concurs with; ‘The most revealing evidence of the US National Cancer Institute’s highly restricted priorities for primary prevention as detailed in its 2001 Cancer Progress Report. The report compared past “progress with the cancer-related targets set forth in the Department of Health and Human Services Objectives for the first decade of the 21st century.” The Report stated that “behavioral factors,” detailed in 19 pages, are responsible for as much as 75% of all cancer deaths in the U.S., while recognizing that “certain chemicals in the environment are known to cause cancer.” However, these carcinogenic chemicals, summarily dealt with in three pages, were restricted to second-hand smoke, benzene in the air, particularly from smoking and occupational exposures, and radon in the home.” (Epstein 2003) (13)
The emphasis on personal responsibility for ill health rather than corporate/state responsibility has been used for decades and Brown is merely following a well trodden path that was laid out in the early 1950’s by a Professor Richard Doll,“the scientist who established beyond doubt that smoking caused lung cancer” and that other factors were all but irrelevant. At that time, medical professionals, politicians, and health educationalists, reached a very speedy consensus on this issue, and other lines of investigation were consequently quickly abandoned. Most research since then has been strongly influenced by and has mainly concentrated on supporting or extending those original Doll studies, to keep that path straight and clear.
This important distinction between personal and corporate responsibility for the state of public health, dramatically changed the whole climate on health in the 1950’s and set an agenda that has survived to this day, as explained above, but has also morphed to include many other personal lifestyle choices such as what we eat and drink. Doll, removed responsibility from industry that was believed to be responsible for most cancers, and placed it squarely on the individual. Is it any surprise to find that Doll was embraced by most corporations and big business? Occupational cancer still remains a low priority, a position in the nation’s public health priorities that can be traced back to Doll/Peto. Its low priority is also reflected in the approach of many health organisations including the Health and Safety Executive, American Cancer Society, British Heart Foundation and Cancer Research UK etc.
Prior to that, and in common with other public health scientists of the pre-war and immediately post-war periods, Richard Doll considered that workers faced the greatest and most consistent threat to their health in the workplace. He considered that an "immense" number of substances were known to cause cancer. Over time, that opinion changed markedly. From initially maintaining that industry and man made carcinogenic substances were the main causes of health problems he did a total ‘about turn’, blaming naturally occurring substances and the individual for their own health problems. Why? Was this driven by some vested interest? (14)
At roughly the same time as his smoking/lung cancer study, Doll, with his colleague Prof Bradford Hill, found a strong link between asbestos and lung cancer and this allegedly put them on a collision course with Taylor and Newall, a big asbestos producer, who had in fact employed them to do the study.
Prof Richard Peto, Doll’s long term collaborator explains about this;
‘In the 1950’s, "Initially the asbestos industry called them [Hill & Doll] to try to prove there was no hazard," he said. The regulations on asbestos had been tightened up. "He and Bradford Hill got the data and found there was still a significant hazard." The company representatives invited the scientists for dinner and tried to persuade them it was not in the national interest to be attacking a major industry, said Peto. Doll and Bradford Hill politely said they would think it over and 24 hours later told the industry they intended to publish. They were threatened with a writ, but went ahead regardless.’ (15)
“Not in the national interest’?
Let me play devil’s advocate here. Let’s assume that for several years it had been known that asbestos was a major cause of lung cancer and smoking was harmless or only a minor cause of ill health. Let us also assume that the government was aware of this.
Actually let’s not assume that! I think it is pretty obvious that they were aware of the hazardous effects of asbestos since at least 1930 and probably much earlier;
In 1857 the first asbestos products appear in England. Production truly begins after this, when deposits are opened up in Canada and South Africa.
In1898. "Reported by a female inspector in the UK Annual Report of the Chief Inspector of Factories; “the [asbestos] effects have been found to be injurious, as might be expected”;
In 1918 the Prudential Insurance Company in New York refuses to sell personal life insurance to asbestos workers;
In 1930, Merewether and Price, medical and engineering inspectors of factories, place before Parliament a report confirming the epidemic of asbestos disease among British asbestos workers. (16)
Let me put these dates into historical perspective.
Asbestos has been around since Roman times but its use was very limited until the mid-late 19th century.
In 1898 the asbestos problem was beginning to be identified amongst the medical establishment and the transformation from the manufacture of wooden ships to metal ones was also well established (asbestos was important in metal shipbuilding). By 1918 it was pretty clear that asbestos was a killer but its applications were becoming more widespread. It was widely used for lagging, insulation, fire proofing. It will not rot or burn is impervious to weather effects, some acids and vermin. Add to that it has a high tensile strength and flexibility, cheap to import and produce and one can see how quickly its use ballooned. There was no real alternative. No other product was available to match its properties or diverse applications and it was particularly well suited to shipbuilding where it was used in copious amounts
In 1930, Parliament is officially made aware and some (very basic) regulations were put in place, but it wasn’t long before the rise of National Socialism and Hitler that represented a threat to Britain and world peace.
Back to devils advocate!
In the mid 1930’s, knowing the threat of war, what is a British (or US for that matter) government likely to do? On the one hand we have the time bomb of asbestos related mortality (latency period 10-60 years), on the other, the immediate need to increase production of warships and other war machinery that were fit for purpose. Is it beyond belief that the government would, in the national interest, risk shipyard workers health in order to defend the country from Nazi Germany and worry about the consequences later?
Of course, once the war ended, the consequences would loom large and if this decision was to be discovered, what would those consequences be? More importantly, how could they be avoided? Could the ‘escape clause’ have been provided by Hill and Doll?
Still playing devils advocate – Assume that the British government were so naive that they were unaware of the true dangers of asbestos. eg. it was merely an unproven theory. We know that Doll was employed, by a large asbestos company, “to try to prove there was no hazard” in asbestos. What if Doll really did want to do just that on behalf of his employer? What better way to give credence to his work and to ‘prove’ his impartiality, than to have the public believe that he was in conflict with the asbestos company over his work that found asbestos to be hazardous! Would he have been believed if he had just come straight out and said asbestos was harmless, whilst working for an asbestos company? (Consider what would happen if scientists, who worked for a tobacco company, were to say that their studies had proved that tobacco or nicotine was non addictive?) – Oh, that did happen didn’t it, but can you remember the result? Incidentally, it is worth remembering that Doll remained on the payroll of T&N for many years after being threatened with that writ? (17)
At this point, it may be opportune for me to make some of the comparisons between asbestos and smoking that provides the basis of and the subsequent development of the illusion;
Cigarette smoking is allegedly the single most important public health problem we face in Britain.
Asbestos is allegedly the greatest single cause of work-related deaths in the UK (HSE)
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Smoking allegedly causes numerous cancers, pulmonary problems, all forms of lung cancer.
Asbestos allegedly causes numerous cancers including pulmonary problems, and lung diseases; Mesothelioma (chest cavity cancer), Fibrosis (scarring of the lungs) and all forms of lung cancer.
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Smoking related diseases allegedly have a latency period of 30 to 40 years
Asbestos related diseases allegedly have a latency period of 30-50 years (or 10 to 60 years depending on who you believe)
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The smoking epidemic is allegedly due to the increase in smoking from the beginning of the 20th century, increasing significantly during the 1st WW.
The asbestos epidemic is allegedly due to the increased use of asbestos starting at the beginning of the 20th century. In 1914 British shipyards were producing more new tonnage, both naval and merchant, than the rest of the world put together. (19) Crocidolite and amosite is used for spraying, thermal insulation from 1920s until 1950.
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The incidence of smoking in the UK peaked in 1945 for men and 1974 for women then smoking begin to decline quickly in both men and women (20)
The import of crocidolite, considered to be the most hazardous asbestos, peaked in 1950, fell by 25% in 1960 and by 88% in 1970. (08) In 1970, the 1969 Asbestos Regulations were introduced, the first major controls in asbestos use. The oil price shock of 1973 plunges world shipbuilding into its worst depression since the 1930s.
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In the 1980’s anti-smoking charities begin their campaign in earnest, towards a ‘smoke free’ society.
During the mid 1980’s more stringent legislation is enacted to control the use and importation of asbestos. The import of crocidolite or amosite is banned. In 1983 shipbuilding is privatised and sees the swift disappearance of most merchant shipbuilding.
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By mid 1990’s smoking prevalence is reduced by more than 50% from its peak.
By the mid 1990’s new asbestos use is all but eliminated from the UK, but much still remains in old machinery, heating systems, buildings, factories etc. The UK shipbuilding industry is all but finished as is most heavy engineering and coal mining.
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According to The US Surgeon General (2006) (and others)“ There is no safe level of second hand smoke”
According to the National Institute for Occupational Health and Safety (NIOSH) (1997) “all levels of asbestos exposure studied to date have demonstrated asbestos related disease” and “there is no level of [asbestos] exposure below which clinical effects do not occur.” (18)
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The most recent comparison;
‘Third hand smoke’; “The invisible yet toxic brew of gases and particles clinging to smokers’ hair and clothing”. (Dr. Winickoff, Harvard Medical School) (20). (21)
“Invisible asbestos fibers cling to clothes, hair, and skin. When they become airborne, as they do in natural movement, anyone near that person can inhale them” (EPA – CDC) (22)
There are other comparisons that can be made between smoking and asbestos, such as signs and symptoms of lung diseases (23) and official risk factors (24) etc. but suffice to say that, taken together one can say, the history, symptoms and effects of smoking and asbestos are almost exactly the same apart from the fact that smoking has always taken precedence as the primary hazard. Smoking allegedly causes 90% of lung cancers; Asbestos causes less than 10%? Is that a coincidence? I think not! Have the signs and symptoms of smoking diseases been engineered to fit with asbestos diseases? It is certainly possible!
With this in mind, is it a coincidence that Doll’s first studies on both asbestos and smoking were done, to all intents and purposes, at the same time?
Back to being devils advocate;
Theoretical meeting/discussion in late 40’s, early 50’s;
“We have a problem! We know that it is highly likely that asbestos is about to cause hundreds or thousands of deaths over the next 50 years or so in asbestos workers! How do we avoid what could be the biggest scandal in history? How do we avoid blame being attached to asbestos companies and/or government which will inevitable involve massive compensation claims?”. “We can never say that asbestos is harmless because there have been too many others who have identified the hazards”.
“Why don’t we blame something else and give it the same characteristics. We can endow this ‘something else’ with all the signs, symptoms, diseases and outcomes and then we can divert attention away from the real culprit, asbestos, by downplaying its effects.”
“What about coal smoke and smog”? “Everyone has a coal fire, there are coal fired industries all over the country and they are more prevalent in areas where asbestos is more likely to be used? Lets just say coal smoke and pollution causes those asbestos health problems, do a couple of studies, one that proves coal smoke is responsible and another that shows asbestos is a problem but only a minor one when compared with coal smoke”!
“Good idea, but Britain is a major coal producer, we need coal fired industry to rebuild the country, produce steel, generate electricity and power steam trains to transport goods, export coal to other countries etc. The government will get the blame anyway because coal has been a nationalized industry since 1947. All that blaming coal smoke will do is to impoverish the nation and the government will have to foot the bill just the same”!
“Okay, what about smoking? Over 80% of, mainly working class, men smoke. Working class men are the ones who are more likely to work with asbestos in shipbuilding, the mines and other heavy industry. Men are more likely to suffer with lung cancer. Their wives mainly stay at home, are unlikely to be exposed to asbestos, less likely to get lung cancer as a result and not many women smoke. It’s been said for centuries that smoking is bad for health; all we have to do is confirm it, play on peoples’ concerns and avoid or downplay the asbestos problem whenever possible... Attention is diverted away from industry and is blamed on the individual. Scandal avoided, compensation claims avoided! .... Perfect” – the illusion begins!
Of course this is no better than a fairy tale; it is all hypothetical, no proof. If this sort of discussion ever took place, it could never be proved. Those involved would be few and no one in their right mind would record such a discussion in any way, shape, or form. We can look at other clues however and there are some very compelling ones too!
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A picture paints a thousand words
I will start with the illustration of England, Scotland and Wales, a map highlighting the incidence of mortality caused by Lung cancer and Melanoma – as compiled in 2005 for the period between 1991 -2001. by The National Cancer Intelligence Centre. (25) Concentrating only on the lung cancer mortality map you will note that the white areas are average incidence, deep blue is where there is 50% less incidence and deep red is 50% more incidence.
You can see immediately that that the deepest red areas are concentrated in only a few, relatively small areas, on river mouths or estuaries;
1.Glasgow and the Clyde;/ Faslane nuclear submarine base at Gare Loch
2.Teesside and the Tees;
3.Sunderland and the Wear / Newcastle and the Tyne.
4.Liverpool and the Mersey;
The next levels of lighter shade red spread out from those areas;- indicating that the further away from the source of the cancer cause, the less affected by it . Note also that there are two small red areas (more obvious on the female lung cancer map), clearly marked in the center of the UK – well away from the coast. These two small red areas coincide exactly with Leeds and Manchester, where two of the biggest asbestos plants were located.(26) (27) (relevant) There are some anomalies regarding Melanoma too but this is not the subject of this paper.
Compare the Map with official statistics of the incidence of smoking in Britain 2005; In the UK, Scotland has the highest smoking prevalence rate at 27%, followed by Northern Ireland (26%), England (24%) and Wales (22%). Within England, men and women in the north-east are more likely to smoke than those of any other region in England (Cancer Research UK 2005). The incidence of smoking has varied over time but the geographic ratio has remained roughly the same. The difference in smoking rates throughout the country are at the most 5% , yet if you live in one of the deep red areas you are 50% more likely to get lung cancer. Almost everyone South of Liverpool is average or up to 50% less likely to get lung cancer! With the exception of a small area in central London where there is a slight increase. Why is there such a wide discrepancy?
This obvious link between geographic location and the majority of lung cancers has never ever been adequately explained. I am afraid I have great difficulty relating those wide differences to the single issue of smoking nor am I convinced by the explanations given by Dr Mike Quinn of the National cancer centre on that illustrated lung cancer map;
"three quarters of cancers were related to smoking and drinking". If we reduced the rates of cancers everywhere to the levels of the best we would prevent 25,000 new cases and 17,000 deaths a year." "more people smoke in deprived areas"."90% of lung cancers could be prevented if people stopped smoking" "Places do not get cancer, people do. The reason areas have high rates of cancer is that people in them are exposed to the relative risk factors for those cancers." (28)
These views are typical of ‘official sources’ but how relevant are they, how much credence can be placed on such statements? Simple logic shows these explanations are totally inadequate.
“Three quarters of cancers were related to smoking and drinking”- Subjective opinion.
“More people smoke in deprived areas” – generally accepted, but are there no deprived areas in London, Birmingham, Cardiff, or in fact almost anywhere in the UK?
“90% of lung cancers could be prevented if people stopped smoking” – look at a few other official causes of lung cancer; Radon: 14% of all lung cancers (2004 EPA) Diet: 20 % to 42% of all lung cancers (Ziegler RG; Willett WC) Air Pollution: 12% of all lung cancers (Karch and Schneiderman) Just add these few up on top of your estimated 90% caused by smoking = 158% already – but there are many more that would increase that figure even more!
“Places do not get cancer, people do.” - But people in certain small areas are more likely to get cancer and the further away from those small areas, the less likely. Location is far more relevant than any other single factor. This will become even more apparent later in this document!
Risks and places! What makes living on the Clyde different from living on the Thames, or the Humber when smoking rates are so similar in these areas? What have the high risk areas got in common, that are different from the low risk areas? What ARE 'the relative risk factors? That is the crunch question!! One thing for sure is that it is NOT smoking!
There is unquestionably some relationship between the processes of building ships and lung cancer. I highlight shipbuilding rather than ships or ports because there are many large ports across Britain where ships ply their trade – The Thames, Bristol, Portsmouth etc. but all the bright red areas are centered on large shipbuilding areas, not ports. The biggest shipbuilding area in the UK is Glasgow and the Clyde area. It was one of the biggest in the world at one time, but has been in decline over the last half century. It is also close to the home of Britain’s nuclear submarine fleet. Is it coincidence that this is the area with the most cases of lung cancer in the whole of Britain? The Wear and the Tyne each had a substantial shipbuilding industry. Ships were also built at Liverpool and the Mersey but not on the scale of the other areas, and this is apparent on the lung cancer map. If lung cancer is something to do with the shipbuilding industry – what is it, where is it?
That common factor is almost certainly; Asbestos! That is the single most compelling factor that all these areas have in common? This link with shipbuilding has been known for some time, yet many still consider smoking to be more culpable? (29) (30) (31) (32)
Asbestos is made up of tiny fibres that can only be seen under a microscope, which can penetrate deep into the lung and stay there causing respiratory disease or lung cancer. Asbestos fibres can float invisibly in the air. These are so small that two million would fit on a pin head. Just one of those fibres inhaled could induce lung cancer. (33) It can also be ingested and cause cancers in the gut.
The EPA (US environmental protection agency) and the CDC (Centers for disease and control) state “We can’t see it, smell it, taste it, or feel it, but we know that asbestos can cause debilitating and often fatal diseases.... What we don’t know is how much – or how little- exposure to asbestos can cause them”
“There is no known safe level of exposure. Anyone who works with any quantity of asbestos for any length of time risks developing serious disease later in life and that person puts others at risk. Invisible asbestos fibers cling to clothes, hair, and skin. When they become airborne, as they do in natural movement, anyone near that person can inhale them” (34) (How far can an asbestos fiber, only visible under a microscope, travel on the wind?)
The advantages of asbestos made it ideal for shipbuilding and the process of extensively spraying asbestos into bulkheads was used widely, fire protection is one of the most important aspects on ships. It was also used for a myriad of other purposes on ships. Of course, spraying, by its nature, will mean that there will be many billions of tiny airborne asbestos particles produced in side-spray – particles that can only be seen under a microscope. Large ships are built in the open air so it takes no imagination to understand what will happen to those side-spray airborne particles – it all depends on the direction and strength of the wind. Those people working with asbestos will have the greatest exposure but even those who do not work with asbestos or have no apparent connection with it whatsoever will also be exposed depending how close they reside to the original source. The further away from the asbestos source the less exposed they become, and the less lung cancers are caused. This dose / response relationship is clearly illustrated on the lung cancer map.
The Coriolis effect that influences the W and SW prevailing winds in the northern hemisphere, (35) is also fairly clear. Lung cancer is spread further afield across the land from the west coast whereas from the east coast, asbestos fibres are more likely to disperse harmlessly into the North sea or travel in more dilute form to northern Europe.
There was one problem with this! Most people only associate asbestos disease with asbestosis and mesothelioma. I had always been led to believe that asbestos causing lung cancers were separate, identifiable and distinct from other lung cancers, and it appears that this is the general perception but it seems that we cannot always tell. According to the Berkshire and Dagenham Asbestos victims support,. HSE have said there are at least 2 lung cancers caused by asbestos for every Mesothelioma (only discovered as distinct from other lung cancers in the 1960’s) , others say there could be many more”. (36) The two most common types of lung cancer are small cell lung cancer and non-small cell lung cancer. Asbestos exposure can be a factor in developing either type of lung cancer. Non-small cell lung cancer accounts for 85% to 90% of lung cancers. (37). According to the National Cancer Institute, small cell lung cancer accounts for approximately 13% of all diagnosed cases of lung cancer. Smoking is almost always considered the root cause of Small Cell LC, as it is alleged to be rare for a person who never smoked to develop this. However, exposure to asbestos is a well-established cause of small cell lung cancer (38) It is also well documented that smokers are far more prevalent in lower social classes and it is these social classes that are more likely to work with or live near industrial areas such as shipbuilding which are also more likely to be areas of social deprivation.
According to Flinders University director of pathology Dr Douglas Henderson, most asbestos lung cancers are NOT diagnosed. He maintains that lung cancers previously attributed to smoking may in fact have been caused by asbestos. (39) I had seen the UK lung cancer map some time ago, and I considered it to be very compelling evidence that could easily be comprehended by a layman. This UK map was easy to understand, and clearly illustrated the link between shipyards, place of residence, asbestos and lung cancer. However, my attention was drawn to a lung cancer map of the USA.(below) and a USA map of smoking incidence (42)
This, of course, killed my theory as it is plain that the majority of Lung cancers are concentrated well inland and well away from shipbuilding. There was also a synchronization of sorts between smoking and lung cancer incidence. The shipbuilding/lung cancer risk was dead, ….. or so I thought ....... until I discovered this map showing the location of US Asbestos tainted ore plants (41), and compared it with the lung cancer maps below;
(LC map 1)
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(Image produced by the en:Centers for Disease Control and Prevention, a subdivision
of the en:United States Department of Health and Human Services 22 March 2007)
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Look how closely these two maps synchronize. The majority of lung cancers are located between the asbestos plants at Oklahoma City and Dallas in the west to Nashville and Wilder in the east. Look at some of the smaller areas too. E.g. Sacramento in the far west shows a clear isolated cluster. Minneapolis and Los Angeles at first glance appear to be in areas of low lung cancers but look closer and even here there is a raised incidence extending eastwards. While these maps show a pretty good comparison, there are still gaps, for instance the low rate of LC in the north of the country. What of all the asbestos plants on the east coast, and what of shipbuilding areas? This map however, is a very recent lung cancer map (2007). Shipbuilding is now almost extinct in USA and asbestos use has been phased out, while many homes, factories, schools etc. still retain much asbestos. As a result, asbestos related lung cancer will be reduced in areas near plants and shipyards, while having more impact on built-up areas as asbestos laden old buildings are demolished or renovated, releasing previously undisturbed fibres into the atmosphere. When asbestos was originally incorporated into buildings there will have been little exposure to asbestos dust. Undisturbed asbestos is relatively harmless and only when the asbestos is drilled or cut would it become a danger. Demolition on the other hand will cause the asbestos to break up and produce masses of dust and deadly particles. Don’t forget the Coriolis effect too.
The map below shows lung diseases over a longer period of time; between1950 and 1994.
(LC map 2)
The link with the eastern and southern seaboard shipbuilding areas and the east coast asbestos plants is clearly illustrated in this map. The shipbuilding link is there but also the affect of asbestos plants.
This next map covering the period 1950 – 69 removes much of the ‘noise’ and puts the comparison even more sharply into focus.
Look closely and you will see that EVERY asbestos plant correlates, to a greater or lesser degree, with an area of high incidence of lung problems – How clear is that!!
(LC map 3)
The variation in quantity/spread of lung cancers is probably an indication of how well each processing plant managed to control the escape of deadly asbestos fibres or geographic topography in terms of the dispersal of those fibres, but the raised incidence is always there. Look at the maps from earliest to latest and it is almost like witnessing a developing viral epidemic with the deep red high rates spreading from a few small localities (asbestos plants/shipyards) to cover greater and greater areas with the top 10% age adjusted mortality rates consistently increasing:-
1969; 47.77-68.89 ............ 1994; 73.79-87.67 .............. 2007; 77.20-119.30
Remembering of course that while lung cancer rates have been increasing, smoking prevalence has been reducing consistently over those same time periods!
1969; 47.77-68.89 ............ 1994; 73.79-87.67 .............. 2007; 77.20-119.30
Remembering of course that while lung cancer rates have been increasing, smoking prevalence has been reducing consistently over those same time periods!
Look again at the smoking/lung cancer map and the connection is much less obvious on all the maps.
Note the clear gaps and anomalies in the comparison between smoking incidence and lung cancers. Eg. Utah has the lowest smoking prevalence and low LC rates too, but it is also well away from asbestos plants and the coast. In map 1, Utah’s low LC rates extend into Nevada with a higher smoking prevalence. – illustrating that the closer to the coast/asbestos plants, the more Lung Cancer. Utah has the same LC rates as North Dakota where smoking rates are much greater (map 3). New Mexico, Wyoming, North and South Dakota amongst others are in the areas of least lung cancer incidence yet smoking incidence is only slightly lower than the highest lung cancer areas (around 20% compared with 24 %.) Conversely, California has one of the lowest smoking rates, with only 14.3% smoking incidence, yet has more lung cancers than any of the above named. The least lung cancers are in areas that have no connection with asbestos.
The advantage of reading these maps is that you do not need to be a scientist, statistician or doctor to understand what they mean; the message is clear and unambiguous. You don’t need to know any complex medical or scientific jargon; eyesight and logic is all that is needed. ‘A picture paints a thousand words’ – or in this case possibly a thousand statistical scientific studies! These cancer maps measure the amount of lung disease per each 100,000 population. It is not a pure count of lung cancers but a measure of incidence by location, so a comparison can be made regardless as to the actual population of any specific area.
This is clear evidence of the association of lung cancers with asbestos plants and shipbuilding in both the USA and the UK. It is also clear evidence of why smoking is not the health hazard that the public have been led to believe. I cannot believe that I am the first person to see this clear association, so why is this not commonly known?
It is clear that the majority of lung cancers are clustered around shipyards and asbestos plants but, of course, people who live nowhere near these locations also die of lung cancer. Is this evidence against the hazards of asbestos? No! Consider the fact that this asbestos spraying process, common in shipyards was not limited only to use there, but was also used in many metal framed buildings throughout the developed world, though geographic concentrations of such use were somewhat less. Asbestos permeates every area in the country and is or has been used in innumerable diverse products such as roofing, boiler and loft insulation, artex, talcum powder, even children’s crayons, etc etc. (44). There is another major area where asbestos was commonly used; in brake and clutch linings in all motor transport.
One scientist who tried to explain why lung cancers were mainly confined to urban areas was Dr Kitty Little. She argued that diesel fumes were the cause of lung cancers and comments that; “lung cancer is rare in rural areas, but common in towns and cancers are more prevalent along the routes of motorways;” (45)
Whilst her studies are valid and very persuasive, I wonder if she considered that every motor car, lorry, bus, motor cycle etc. until very recently, was fitted with asbestos brake and clutch linings? (a few still are) Asbestos linings have steadily been phased out and have not been fitted to motors since around 2003 but many will still have been used since that time and in many countries they are still produced, particularly third world countries as this advertisement from Gulbros Brakes Ltd, India shows (46). Every time a driver brakes or changes gear, a tiny amount of asbestos dust is produced and released into the environment which is then stirred up and spread by the wind and other passing vehicles. Multiply that by the millions of motor vehicles being driven on the roads every day and that small amount of asbestos dust, while not in the same league as shipbuilding, becomes quite substantial. Common logic tells us that this asbestos dust will be most concentrated in towns and along major roads and motorways!
Who is this most likely to affect? – Well, everyone, particularly those who live in inner city or urban environments, or near main roads, but more specifically, those closest to the source of the asbestos brake dust and diesel fumes – little people; children and babies in push chairs! Anti-tobacco put great emphasis on protecting ‘the children’ from passive smoking by exaggerating its effects, to promote an emotive response against smokers and smoking, yet most pre-tainted research shows it to have a protective effect on children; Read ‘passive smoking’ ‘the evidence’ in Velvet Glove, Iron Fist’ (47) and (48) (49). In another case a WHO study that they lied about (50). Yet asbestos, it seems, is unimportant!
The hazardous effects of asbestos brake dust have largely been kept in the background with warnings mainly restricted to those who actually work with motors; No warnings to mothers or other public health warnings to my knowledge. The essential measures to restrict use of asbestos brake linings have eventually taken place in the developed world, but many, many years after they should have been implemented. Any reduction in cancer statistics as a result of effective asbestos controls will, of course, be attributed to smoking bans!
Over the last half century, society has changed dramatically. We have seen a decline in the male dominated workplace and an increase in female members of society entering the workplace. Woman’s role in modern society has changed from a predominantly home based domestic role to a wider role in work and industrial society. The decline in shipbuilding, heavy industry and mining etc were traditionally male dominated and the reduction in use of asbestos because of this, coupled with asbestos controls, has meant fewer men are being exposed to that form of asbestos contamination. Women on the other hand, have increasingly placed themselves at the same risk of asbestos contamination by entering the workplace. The increase in motors and subsequent increase in that form of asbestos dust contamination will equally affect both male and female as will the release of dust from demolishing and upgrading buildings. These changes in gender roles are very clearly illustrated in their now converging respective lung cancer risk. Anti-tobacco sources claim that the increasingly similar gender LC risk is because women started smoking later in history than men and have increased their smoking while men have reduced theirs. This may have some merit but I would suggest that it is no more than a very convenient coincidence. It is more than clear that as the disparity between male and female asbestos exposure risk closes, so lung cancer prevalence is reaching gender parity. It is more to do with men being less exposed to asbestos rather than women being more exposed to tobacco smoke, with both being more equally exposed to similar quantities of asbestos.
Could this be the most successful illusion ever conceived or perpetuated? Has sleight of hand surreptitiously transferred the hazards from asbestos to smoking? Look at how those hazards have magically disappeared from asbestos in the one hand and reappeared in tobacco smoke in the other.
“Asbestos has been recognised as an important risk factor for lung cancer for many years. However, although lung cancer death statistics for Great Britain are readily available, the number of deaths attributable to asbestos cannot be determined directly. This is because there are a number of agents that can cause the disease - most importantly, tobacco smoke - and lung cancers resulting from asbestos exposure are clinically indistinguishable from those caused by these other agents.”(HSE statistics) (51)
Is this one of the best examples of the relationship between power and money? Money corrupts and he who has the most money controls the information, the debate, and often the outcome. For decades, the anti-smoking campaign has protected the interests of the asbestos industry, but also the nuclear industry, the chemical industry, many other polluting industries and, dare I say; elected Governments! Governments wouldn’t become involved in any cover-up would they? This press release in 2002 regarding ‘The Smog Conference’, indicates otherwise; “… governments from the late 50s onwards deliberately downplayed the huge threat to public health caused by air pollution, and sought to shift the blame firmly onto cigarette smoking instead” (51a)
Ultimately however, illusions are never permanent because they are simply not real and are only as good as the skill of the magician who practices those illusions. The sooner someone, with the power to do so, has the courage to introduce the open candle of truth into the house of straw commonly known as ‘anti-tobacco’, and reduces that pernicious house to ASH, (Forgive the pun) the sooner society can return to normality where truth, integrity and tolerance are reinstated. Exaggeration of the effects of smoking coupled with denial of the hazards of asbestos has effectively caused the death of millions which, from the outset, appears to have been purely to protect corporate interests and/or for political expediency. This sadly continues today.
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Asbestos, Smoking and the art of Illusion (2)
Deception, Flawed Scientific Study and Propaganda
(How to create and maintainthe illusion)
I have already alluded in (1) to what I consider to be some of the reasons why I consider the anti-smoking campaign to be the greatest ever illusion, practiced to protect industry. The maps below illustrate how clear clusters of lung diseases synchronize almost exactly with Asbestos plants and Shipyards in the USA. Similar clusters are clear around shipyards where asbestos was heavily used in the UK. These maps do not require the reader to have any expert knowledge in statistics, science or medicine to understand the implications.
It would be interesting to look a little closer and compare some of the ‘science’ in relation to smoking and asbestos in order to put this information into context. How have the hazards of asbestos come to be perceived to be relatively insignificant while the hazards of tobacco smoke have been amplified beyond reason?
Professor Sir Richard Doll; The anti-tobacco prophet.
Prof Doll was knighted by the British Government for his work into smoking and health but you do not need to be a scientist to be able to assess this history lesson.
After his death in 2005, it became public knowledge that Doll had received substantial payments from diverse corporate interests. These included, amongst others Monsanto, the chemical industry, The British Nuclear industry and Turner and Newall, the asbestos producer. Not only that but while many such payments were disclosed, many other payments were made secretly. (injury watch) (52)
During his career, Doll has defended all of these manufacturers and other industries too, but he has also been accused of manipulating scientific information. He has defended the use of fluoridation of drinking water and consistently trivialised the role of occupational and environmental causes of cancer, such as asbestos, Dioxin (Agent Orange), vinyl chloride and man made radiation.
In 1982 Doll reassured workers at Turner and Newall asbestos plants that the new exposure limit, recently set, would reduce their lifetime risk of dying from cancer to "a pretty outside chance" of 1 in 40 (2.5%). This, however, is an extremely high risk. It has since been shown to be much higher (53)
In 1987, Doll dismissed evidence of childhood leukemia clusters near 15 U.K. nuclear power plants. Faced with evidence of an excess of lymphoid leukemia in children and young adults living within ten miles of these plants, Doll advanced the novel hypothesis that "over clean" homes of nuclear workers rendered their children susceptible to unidentified leukemia viruses. (Do only nuclear workers have ‘over clean’ homes?)
In a 1992 letter to a major U.K. newspaper, Doll pleaded with the public to trust industry and scientists and to ignore warnings by the "large and powerful anti-science mafia" of risks from dietary residues of carcinogenic pesticides.(Appeal to authority – we are the experts! - and ad hominem attack on the bad guys, the ‘anti-science Mafia’ ) (54) (55)
For further information on Doll – read; SIR RICHARD DOLL: A QUESTIONABLE PILLAR OF THE CANCER ESTABLISHMENT by Martin Walker (1998) and this; Sir Richard Doll – ‘Smoking and Cancer Alarm False’
I would like to make one very important point at this stage. I have looked closely at the work of Prof Doll and have criticised much of it, however, it is not my intention to show that he was corrupt. I do not believe that to be so. He was just very competent at defending his employers and has clearly done so to the best of his ability. I consider him no more corrupt than a barrister who in a court of law defends, to the best of his ability, any alleged offender, regardless as to whether that person is guilty or not.
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Early influential study on smoking and health
Dolls most famous study into smoking and lung cancer is his ‘Doctors Study’ but he did one prior to that with Bradford Hill. This one involved 1500 lung cancer patients and a similar control group at various hospitals that ‘positively and incontrovertibly’ proved that smoking caused lung cancer. This was an early epidemiological study that used questionnaires which recorded smoking history etc. Its methodology was criticised by a number of scientists, on the failure to properly account for confounding factors, the fact that correlation does not equate to causation, and other basic flaws. In 1958, Sir Ronald Fisher, a well respected statistician (56) identified numerous flaws, but as Fisher points out, the study produced ‘overconfidence’ in the results, such that the medical establishment believed they had found the solution and had ‘the game in the bag’. That overconfidence he believed had resulted in the failure to follow other lines of inquiry into other aspects such as genome study and importantly, “The very striking fact that at the same level of cigarette smoking, dwellers in towns have considerably more lung cancers than dwellers in the country”
Fisher also astutely identifies the beginnings of the rise in anti-tobacco propaganda using “all the devices of modern publicity” that was evident at this early stage of the smoking campaign and the fact that some 19 other studies that concurred with Dolls study appeared to be “mere repetitions of evidence of the same kind”. (Some would argue that this is still the case) (57)
One of the most important facts that serve to illustrate the flaws in Doll’s later work resides within this study. Fisher points to one question that was in the study questionnaire; “Do you inhale?” Innocuous question you may think, but it turned out that it was of great importance. Doll and hill stated in early reports that “The additional amount of lung cancer observed in patients was proportional to the amount of tobacco consumed”. That was soon withdrawn however, (although later reinstated – common tactic used many times since, to ‘appeal to authority’) presumably when they found that “there were fewer inhalers among the cancer patients than the non-cancer patients”. Stop and think about this for a moment, Smokers who didn’t inhale were more likely to suffer from lung cancer! The implications on the validity and conclusions of the study are obvious. Fisher considered this to be important and anyone with any sense would consider this an important finding. Doll and Hill however, are alleged to have considered this not to be important at all. I suspect they did and because they did, the question was not initially asked in the subsequent Doctors study!! They later reintroduced the question about inhaling only to find that their results continued to show the inhaling/non-inhaling paradox. Could it be argued that not only had they discovered the cause of lung cancer (cigarettes) but also that they had discovered the means of its prevention (inhaling cigarette smoke)?
Doll and Hills ‘Doctors study’ is also subject to criticism by Profs J. R. Johnstone, & P.D.Finch, in their paper ‘The Scientific Scandal of Antismoking’ (2006). They argue that Doll’s uncontrolled trial study was inferior or second rate compared to others based on ‘randomised controlled intervention trials’. They quote the 1968, 20 year ‘Whitehall study’ and the WHO ‘Multiple Risk Factor Intervention Trial’ or MRFIT, as examples and how these, they describe as, ‘gold standards’ in medical research would firstly be ignored then mis-represented, because they did not produce suitable results. (57)
The ‘Doctors study’ is usually quoted when evidence is needed to prove the smoking/lung cancer risk, but this was always the intention. Writing in the December 2001 issue of the British Medical Journal, Doll wrote that the study was “devised by Sir Austin Bradford Hill to achieve maximum publicity for the critical link between smoking and lung cancer”. Does this mean that they did not set out to conduct a serious scientific study into the effects of smoking but merely had the intention of creating propaganda based on their own agenda?
This brings me to the actual methodology. Not only was Doll one of the first to link cancer with smoking, he did it using the newest branch of science called epidemiology, (basically, the study of epidemics) that has its origins in statistics and complex mathematics.
The first effective use of epidemiology in smoking research was actually during the 2nd World war when German tobacco epidemiology was the most advanced in the world. Franz H Muller in 1939 and Eberhard Schairer and Erich Schoniger in 1943 were the first to effectively use case-control epidemiological methods to document the lung cancer hazard from cigarettes. Hitler, who was a fanatical anti-smoker, clearly had more than a passing interest evidenced by a 1941 donation of over 100, 000 RM out of his personal resources to fund the establishment of the Jena Institute, The Scientific Institute for the Research into the Hazards of Tobacco,(58) an institute whose very name indicates clearly its prejudicial intent: Everyone knows that Hitler passionately embraced propaganda to further the Nazi agenda and epidemiological study was one area very easily manipulated to produce such propaganda. Hitler and the Nazi party were defeated in the 2WW but their spirit lives on in the form of tobacco control using that same ‘science’ that is so easily manipulated.
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The limitations of epidemiology
Doll was a pioneer in this type of study in the UK, learning well from these earlier studies (Doll, worked in Germany as a young man). The primary problem with epidemiology is that at the end of the day, it is essentially statistical study and surely everyone should now know that statistics can be used to prove anything that the study is intended to prove. The inherent flaws are so numerous that while I will point to a few problems, I have no intention of explaining them all in this document; it would need a large book to do it justice. For instance, it will suffer from all kinds of bias; research bias, sampling bias, subject bias, recall bias, publishing bias etc. It will be affected by confounding factors, risk factors, social factors, lifestyle factors, geographic factors and interpretation etc. – the list goes on and on! The limitations on epidemiology have been known for many years yet it is still used to indicate and ‘prove’ causation.
“Epidemiology has often been criticized severely for its lack of scientific discipline and disregard for customary safeguards; it is inevitably observational rather than experimental, and hence subject to the usual problems inherent in scientific argument relying on purely circumstantial evidence, rather than direct empirical testimony (Eysenck) (59) Epidemiology is the ‘perfect science’ for anyone with an agenda intent on ‘proving’ their case by ‘science’. Epidemiology is a very unreliable and imprecise measurement of health risks and, in many an opinion, can never prove causation; it can only provide correlations or indications. In criminal law, epidemiological evidence would normally be seen as circumstantial or even hearsay evidence; it is useless without other evidence that would corroborate it.
Lord Nimmo Smith, in Mrs Margaret McTear (pursuer) v Imperial Tobacco Limited (defenders) (2005) in his judgment after hearing much ‘expert witness’ testimony, and not disputing that smoking may be hazardous to health, said;
[9.10] “In any event, the pursuer has failed to prove individual causation. Epidemiology cannot be used to establish causation in any individual case, and the use of statistics applicable to the general population to determine the likelihood of causation in an individual is fallacious. Given that there are possible causes of lung cancer other than cigarette smoking, and given that lung cancer can occur in a non-smoker, it is not possible to determine in any individual case whether but for an individual's cigarette smoking he probably would not have contracted lung cancer” (60)
Many epidemiologists argue that causation can be proved if sufficient studies produce a ‘statistically significant’ result and these can be replicated with the same results. But is this the case? In my opinion, and many others too – NO! Epidemiology does have its place in scientific study to indicate ‘possibilities’ but not in producing hard evidence of causation.
100% of human beings breathe air – does that mean air is responsible for 100 % of deaths – we all die eventually! There is a strong ‘statistically significant’ relationship between the increase in ice cream consumption and a rise in shark attacks. Do increased sales in ice cream therefore cause shark attacks? This correlation could be studied over and over again and the results would be the same I suspect. Should we immediately be closing down ice cream parlours because of this startling discovery? Of course not, this is a correlation NOT proof of causation. It is more likely that ice cream consumption increases with an increase in hot weather, and people are more likely to go swimming to cool down thereby increasing the likelihood of encounters with sharks. But, it would be easy to read into this that hot weather causes shark attacks, the sun is responsible, or swimming is responsible. Sunlight or heat makes sharks more aggressive, cool water makes them turn into nice sharks or ice cream smells terrible or they love the taste so they attack. How many of those attacked had been eating ice cream before, how long before? Was the ice cream vanilla or strawberry flavour? Were victims wearing black or white swimming costumes, riding surfboards, in deep or shallow water, sandy or rocky sea bed etc? .......... Okay, a bit facetious, but this does highlight the problems that arise in epidemiology study relating to confounding factors and deciding what is or is not relevant to a particular study, or what, in fact, is being measured! Who decides what is relevant and what adjustments need to be made to account for them? Inevitably, bias plays a major part.
S. Stanley Young of the National Institute of Statistical Sciences in the article; “Everything is Dangerous: A Controversy”, (61), argues that “Empirical evidence is that 80-90% of the claims made by epidemiologists are false; these claims do not replicate when retested under rigorous conditions” and states; “I think medical observational studies are important and can be analyzed in a matter that claims are dependable. Epidemiologists are well versed in statistics and are capable of defending their paradigm”.
Doll & Peto – the patron saints of the profession – concede that epidemiology is not science but an exercise in imagination. (Doll R, Peto R. The causes of cancer. J Nat Cancer Inst 1981;66:1218)
The main criticism of epidemiology is that because of the number and complexity of confounding factors, it is inevitable that some will be missed and not accounted for, but Lauren A Colby; (62) alludes to the opposing problem of the ease at which studies can be skewed by exaggerating confounding factors and using selective ‘adjustments’
“Give me the ability to “adjust” the figures in a study, and I’ll make any study prove my point. Suppose I have a group of smokers and another group of non-smokers and it turns out that the lung cancer rate among the smokers is twice that among the non-smokers. I have data on the age, sex, ethnicity, occupation, educational attainment and various other characteristics of the study subjects. I look over the data and see that a disproportionate number of the smokers with lung cancer were steel workers. I decide that lung cancer must be an occupational hazard of working in steel mills, so I make a little “adjustment”, throwing out the steel workers who are smokers. Now, I have, perhaps, an equal lung cancer rate for the smokers and non-smokers. But that’s not good enough. I want to prove that smoking is good for you. So, I look around for another factor that I can adjust. Maybe, if I take out people of Irish ancestry that will do the job so I run the data through my computer to see whether it works. Maybe it does, and I have now reached the result that I wanted. If it doesn’t, I can just try another factor.”
“Of course, if I did that, I’d be justly and roundly condemned as a fraud and a charlatan”. “But such is the climate of public opinion that anti smoking “scientists” get away with this all the time”.
Look at smoking studies and you will find that asbestos is usually a known minor confounding factor or more likely, not even considered. Look at asbestos studies and you will find the opposite – smoking is considered a known major confounding factor. The result of this of course is to statistically reduce asbestos related mortality and increase smoking related mortality. This may be malicious in some cases but I would suggest that in the majority it is merely using a ‘given understanding’ of the culpability of smoking with no overt intention of foul play. It is purely accepted as a legitimate, long standing principle.(most likely based on Doll’s studies) The resultant studies however would still be fatally flawed, right from the very beginning, even before the first data were obtained. Hundreds of studies have gone along this path, repeating the same induced basic flaws producing the same flawed results.
If you are wondering why I have previously explained Doll’s contribution to the extent that I have – this is one of the main reasons. His continuing, all pervading influence has been the benchmark from the very beginning and throughout the anti-smoking campaign. His studies have basically set the level of the ‘known confounding factor’ in smoking. Doll’s influential counterpart in 1950’s USA was a Dr Ernst L. Wynder, who it is said, inherited his father’s antipathy towards tobacco and alcohol, worked with Doll and produced other epidemiological study in the same vein. Wynder’s father was a revivalist preacher.
Dolls studies appear to be set in stone, his research methodology has been accept by most as valid and all other study emanates from these ‘given standards’ set by him and his cohorts over half a century ago. It equates with the analogy that in Mathematics, Pi = 3.142. Mathematicians accept Pi as constant, set in stone, and used as a basis for all sorts of calculations. Doll, I would argue, has set the proverbial constant measurement at 4.142 (What would happen to the calculations if mathematicians were led to believe that Pi = 4.142 instead of the correct measurement of 3.1415926535...? )
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‘Blasphemous’ Scientists and the Demise of Scientific Integrity!
Anti-tobacco scientists, commentators and organisations will defend the basic tenets of the smoking/lung cancer danger with fixated vigour and it is deeply ingrained in certain sections of the scientific community, such that anything that is at odds with that basic tenet will be attacked without mercy.
One good example of this is the response to the Kabat/Enstrom SHS study that concluded; “The results do not support a causal relation between environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect.”(63) In a response to this study in the BMJ (64) there were a number of comments that highlighted that fanatical vigour to denounce ‘wrong’ studies by many, so called, ‘well respected’ persons. Fortunately, some scientists did defend E & K;
One comment that was of interest in relation to scientific integrity was made by William L Holden, VP, Global Head of Pharmacoepidemiology, Lyon, France. He related an experience in his student days when doing an epidemiological dissertation. For various reasons, he stated he did not include smoking as a confounding factor; “I was told that smoking explained all the findings (a patently idiotic suggestion), that I should change or delete some references and quotations which questioned some of the 'basic tenets of public health' (ie, that smoking is the cause of all [public health] evil)”... ” I am shocked (somewhat) and disappointed (gravely) that this nonsense continues today. It's not just the integrity of epidemiology that we have to be concerned about, but science in general. Albert Einstein wrote that, 'The right to search for truth implies also a duty; one must not conceal any part of what one has recognized to be true.' I'm glad that Dr Enstrom and others like him understand their duty - they are not alone!”. There are other scientists on that site who also outline personal experiences of being shunned and were strongly criticized because they reported findings that did not conform to the ‘consensus’.
Enstrom and Kabat are examples of how it seems that any scientist who goes against the ‘consensus’ will be isolated and hounded out of the profession. The American Cancer Society (ACS) changed their funding policy in the wake of their study, refusing to grant money to any researcher who had ‘ever received a cent from the tobacco industry’ or any of its associated organisations! (65) (Velvet glove iron fist – ch10). Other attacks on these scientists here; (66) (67). Elstom’s and Kabat’s experience is only one symptom of the demise of impartial research. Since Doll’s time, medical research is increasingly being funded and effectively directed by the powerful Pharmaceutical industry.(noticeably more so since the appearance of nicotine replacement products). Genuine, impartial research is sadly becoming a rarity.
The tendency to inflate research that supports anti-tobacco principles and makes any opposing argument ‘disappear’ is inherent in the anti-tobacco paradigm. Commenting on studies the US Surgeon General supports and uses to justify the smoking and health campaign, J. R. Johnstone, & P.D.Finch, in their paper ‘The Scientific Scandal of Antismoking’ state;
“It may now be apparent why there is such a general belief that smoking is dangerously harmful. There are 3 reasons. First, studies which in any other area of science would be rejected as second-rate and inferior but which supports antismoking are accepted as first-rate. Second, studies which are conducted according to orthodox and rigorous design but which do not support the idea that smoking is harmful are not merely ignored but suppressed. Third, authorities who are duty-bound to represent the truth have failed to do so and have presented not just untruths but the reverse of the truth. (57)
In relation to ETS; "At New York’s 1975 World Conference on Smoking and Health, Antismoking activists were told that to eliminate smoking it would first be essential to;
“create an atmosphere in which it was PERCEIVED that active smokers would injure those around them, especially their family and any infants or young children…” (Huber. Consumers Research Magazine. 04/92)
The anti-smoking propaganda machine duly responded to this call to arms and has been on full throttle since then to make people ‘perceive’ that SHS is harmful.(Create the illusion). However, it did not reach its full potential and move into overdrive until the massive money grab that resulted from the US master settlement agreement in the mid 1990’s. This provided almost unlimited funding to produce unlimited research studies to ‘prove’ that SHS was harmful and funded a massive propaganda campaign to condition the public, whilst at the same time stifling genuine independent research and gagging the tobacco companies. Then Big Pharma took advantage of this as a good marketing campaign to sell their nicotine replacement therapy. They pumped (and continue to pump) millions extra into anti-smoking bank accounts. This blog (68) looks deeper into the pharmaceutical industry’s millions of dollars involvement, and the lucrative benefits they gain in that involvement in the anti-tobacco campaign. Eg. US NGO's (ACS being one such NGO) are allegedly backed by $200,000,000.00 + from the Robert Wood Johnson Foundation. (Johnson & Johnson) - Pharmaceutical nicotine product sales is a $500,000,000.00 + annual business? - Not a bad return for the outlay!
Of course, governments throughout the world have increasingly been infiltrated by anti-smoking zealots and ‘advisers’, fallen head first for the anti-smoking deception and have used copious amounts of taxpayers money to fund anti-tobacco’s ever insidious campaign. Hundreds of scientists have been able to get their snouts into big troughs, and take advantage of these ‘spoils of war’, the only condition apparently being that they produce the ‘right’ results. Doubtless, any scientist with a strong ethical disposition will wisely have avoided this branch of medical science.
The anti-smoking movement has since used what I term the tactic of ‘cluster bombing’– Swamp the media and public with their studies producing more and more fallacious claims of smoking ‘harm’ - just keep on producing flawed study after flawed study to try to discredit real independent study and claim that the more recent the study, the more up-to-date it is and the more it can be trusted. Produce so much and brow beat the public into submission – the very essence of propaganda.
The Tobacco Master Settlement in the 1990’s extorted a quarter of a trillion dollars from tobacco companies and reined in independent, impartial research to the advantage of the pharmaceutical industry. “Following the passage of laws that eliminated the tobacco companies' ability to provide evidence in court for their defense, the tobacco companies were forced to settle” (69)
This was not all bad news for the tobacco companies; It was pointed out that “The big four tobacco companies agreed to pay the state governments several billion dollars but the government in turn was to protect the big four tobacco companies from competition. The Master Settlement Agreement, some argue, created an unconstitutional cartel arrangement that benefited both the government and big tobacco”. The settlement basically prevented further litigation against Big T and all they did was to pass on the costs to smokers. In addition, anti-tobacco is effectively working FOR the tobacco industry in their campaign to tackle counterfeit and smuggled tobacco. If they are successful, Big T stands to increase their profits even more. If we look at, for instance, British American Tobacco (BAT), we see that since the Master Settlement Agreement BAT’s profits have increased substantially and their share price has increased six fold while other, non-tobacco companies, are folding by the dozen. An unwritten rider to this was that the tobacco industry would not argue against the ‘consensus’ that smoking was bad for health. Having said that, why would they want to ‘rock the boat’, given their protected monopoly position, tacit protection from future litigation, and obvious corporate success.
Incidentally, I hope that all the lawyers involved in the master settlement agreement were not like wealthy Richard "Dickie" Scruggs. He was imprisoned recently for bribery and his associates barred from representing any policyholders in lawsuits against State Farm Fire and Casualty Co. over Hurricane Katrina damage (70) (71)
Many universities have adopted policies not to accept research money from the tobacco industry (or more likely, coerced to adopt that policy by threats, either express or implied, to withdraw future pharmaceutical funding) In effect this is tantamount to saying that any research that differs from that of anti tobacco, or is contrary to whatever the pharmaceutical industry deems to be suitable research, will not be tolerated (72)
Of course Lung cancer is not the only health issue subjected to cluster bombing of junk science. New research is being produced at a phenomenal rate into many other areas, to challenge for instance, older studies on the benefits of smoking. This is done apparently with the express, pre-determined, intent to demonise the deadly weed and to suffocate those original studies. It is irrelevant whether or not this research is valid, as long as it has the label ‘science’ so the reader ‘believes’ it is impartial and genuine. I would be very surprised if this is so after looking at recent examples. Take the example of heart problems as they relate to the ‘smoking epidemic’. These have also received the same invidious attention. The US Helena heart attack study and the Scottish Pell heart attack study are two examples. In both cases the claims of the reduction in heart attacks were promoted as being related to the success of smoking bans and these claims were widely reported by the popular press throughout the world. When these studies were later exposed as erroneous, very little press coverage was forthcoming. A year later, the fairy tale ‘reduction’ in heart attacks turned into actual increases in heart attacks, reversing a decade long trend, but not one member of the popular press reported this! What is more, anti-tobacco sources continue to quote the original flawed and discredited studies as correct! (73) (74) (75) (76) (77) (78)
Stanton Glantz a leading US anti-tobacco activist, inadvertently summed up the crisis in scientific integrity when, in 1992 he said,
"…that's the question that I have applied to my research relating to tobacco. If this comes out the way I think, will it make a difference? And if the answer is yes, then we do it, and if the answer is I don't know then we don't bother. Okay? And that's the criteria." (The Anti-smoking convention, Los Angeles, CA, October 2, 1992, "Revolt Against Tobacco." Transcript p. 14) (79)
In 2004, Nicolas Regush, an investigative reporter on health issues, accurately commented on the crisis in medical research;
“There is no way to be nice about this. There is no point in raising false hopes. There is no treatment or vaccine in sight. There is no miracle breakthrough on the horizon. Medicine, as we know it, is dying. It is entering a terminal phase. What began as an acute illness reached the chronic stage about a decade ago and progression towards death has been remarkably swift and well beyond anything one could have predicted. The disease is caused by conflict of interest, tainted research, greed for big bucks, pretentious doctors and scientists, lying, cheating, invasion by the morally bankrupt marketing automatons of the drug industry, derelict politicians and federal and state regulators — all seasoned with huge doses of self-importance and foul odour.”
Now even public consultations are being ‘fixed’. Democracy and freedom of speech is under threat. The British government (DOH) ‘public’ consultation on the proposal to remove retail tobacco displays, hints at the way the public are being treated as insignificant; "Of the 96,000 replies, over 80,000 were from government sponsored agencies." (80) “The Department of Health appears to have deliberately omitted evidence offered by the Tobacco Retailers Alliance” (81). Here is one that represents 2 million workers! (81.1). No doubt, this will be classed as one response. This really is absurd, Government are sponsoring lobby groups to lobby government to give the false impression of public participation!
In the EU parliament, Avril Doyle MEP has been fighting for implementation of World Health Organization’s (WHO) Framework Convention on Tobacco Control, Article 5.3, which requires its signatories (countries) to prevent lobbying by tobacco companies on any public health policies.(82). This is an overt threat to freedom of speech and a veiled attack on anyone who has the temerity to question anti-smoking rhetoric. (Concerned individuals could be considered lobbyists for tobacco companies in this new way of gagging any dissent) ‘Anti-tobacco’ (including the WHO) controls smoking research already, but wants to control anyone who wishes to speak out against them - using the EU parliament. Who are the WHO? How are the WHO directing Worldwide government policy? Who are the WHO obligated to and controlled by? (clue - they sell smoking cessation products) ; (83) (84)
In effect, Big Pharma are moving ever closer to having total control of scientific research, and the ‘truth’ about the harm caused by tobacco etc, ably assisted by tobacco control activists and groups such as the WHO, ASH, CRUK, ACS etc, endorsed by our elected representatives, both in the UK and the EU (85), while genuine ethical research has been rendered impotent. A frightening scenario! Is it any wonder that since the mid 90’s very little, if any, scientific research into smoking can be trusted? It has been corrupted through and through by money and greed. This lack of integrity, clear today, inevitably leads to suspicion of all previous research related to tobacco control. What was previously accepted as absolute and indisputable, needs to be revisited, re-examined and reassessed. (How long has this been going on?)
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Asbestos Research v Smoking Research
“Asbestos has been recognised as an important risk factor for lung cancer for many years. However, although lung cancer death statistics for Great Britain are readily available, the number of deaths attributable to asbestos cannot be determined directly. This is because there are a number of agents that can cause the disease - most importantly, tobacco smoke - and lung cancers resulting from asbestos exposure are clinically indistinguishable from those caused by these other agents.”(HSE statistics) (51)
It is common to see the emphasis placed on, and bias against smoking in the introduction to any study into lung cancer. They invariably have a comment such as “apart from smoking ........”. This one on lung cancer and gender by the WHO is typical;
“lung cancer is highly associated with tobacco consumption, but also occurs in those who have never smoked. This implies that external factors, such as environmental tobacco smoke (ETS), need consideration; in addition, research has suggested that exposure to domestic pollution (e.g. emissions from cooking fuels) and to environmental pollution may also have an impact on lung cancer incidence rates”. The objectives of this paper are threefold: firstly, to review what is currently known about sex and gender influences on lung cancer risk; secondly, to offer suggestions as to the kinds of research questions that need still addressing; and thirdly, to identify mechanisms that can contribute to the engendering of lung cancer smoking research (87)
Note the emphasis on the suspected causes; Smoking first, environmental tobacco smoke (ETS) next, then domestic pollution and apparently as an afterthought; maybe, just a little bit, possibly, environmental pollution (not even any explanation what is meant by that). Then the objectives appear to want to ‘contribute to engendering smoking research’. As a self confessed cynic, It seems to me that the results have not only been foreseen, but planned. Ignoring asbestos as a factor in lung cancer studies is common (or indeed general pollution). I am not aware of ANY research into asbestos environmental pollution beyond known exposure of asbestos workers, their families and the immediate vicinity of asbestos factories. No study (that I am aware of) addresses the relationship between lung cancer and what is in my opinion the single most important factor associated with lung cancer. That factor is not so much if, or how much, a person smokes; more how close or distant they live, or work, from any form of asbestos contamination. ETS has long been discredited as a danger by independent commentators, but ‘official’ scientists insist that it is substantial when they have never been able ‘prove’ more than a tiny 25% increased risk (and this is challenged). Asbestos is known to be a serious contender in lung cancer causes yet it does not even deserve a mention in this study.
It is of course relatively easy to find out who smokes, has smoked or has been exposed to tobacco smoke – just ask. Ascertaining or measuring exposure to microscopic asbestos fibres on the other hand is impossible! A few people will know or suspect that they have been exposed because they have worked with, lived with or have been near to those who have worked with asbestos, but 99% of the population will not have any idea that they have been exposed! Asbestos exposure simply cannot be measured! Smoking studies have taken advantage of this and just ignored possible asbestos exposure. Out of sight – out of mind! The asbestos/shipbuilding/lung cancer maps would appear to be the only current way of ascertaining asbestos exposure.
The asbestos situation can be loosely compared with Typhoid fever in the 19th century. There were many theories on the causes of typhoid until it was discovered that all outbreaks of typhoid were related to location - in particular, how close victims lived near certain water wells. As a result of this observation, it was eventually discovered that typhoid was a water-borne infection. Risks and places? Just as water from the well was the only possible source of infection common to all those who died of typhoid, so I suggest, is the asbestos plant or the shipyard, for lung diseases. Smoking research has diverted attention away from this obvious connection.
Here is another from ‘Health Scotland’ with the ‘study aim’ .. ‘to estimate the number of deaths from the major smoking-related causes of death in Scottish adults which can be attributed to passive smoking’
‘...Using relative risks for active smoking and lung cancer which are an average of those derived from the Renfrew/Paisley study and the UK Doctors’ Study’.... ‘The relative risks for lung cancer in the West of Scotland are low compared to most other studies of lung cancer and smoking. This is because the rate of lung cancer in lifelong non-smokers is higher than in most other studies. It is not clear exactly why this is so but asbestos exposure among shipyard and other workers is a strong factor’ (88) ‘It is not clear’ – really?
As outlined earlier, epidemiological study into asbestos related disease and mortality, apparently without exception, deems smoking a major confounding factor. The study ‘Asbestos and lung cancer in Glasgow and the west of Scotland.’ by the West of Scotland Cancer Surveillance Unit, Greater Glasgow (BMJ 1993) is another good example and also very relevant in relation to location. This is the lung cancer capital of Britain – possibly the world, yet it concluded that an estimated 5.7% of lung cancers (1081 cases) were asbestos related, in men registered in the west of Scotland during the period 1975-84.
The study explained (in relation to confounding factors) that;
“Correction was made for past cigarette smoking, air pollution and deprivation”
“Past cigarette smoking was measured by mortality from chronic bronchitis (ICD codes 490-1, 492,496), a strong correlate of the prevalence of smoking. Data obtained from the registrar general of Scotland1975-84”
“Over 70% of the variation in the incidence rates of lung cancer was accounted for by the four independent variables in the model, with the major explanatory variable, the proxy for cigarette smoking, accounting for 54%” (WOW, how many lung cancer/asbestos cases has that excluded at a stroke?- Pi = 4.142 again)! (89)
According to this study, only 5.7% of lung cancers are asbestos related. Can anyone NOT see the obvious dichotomy between this tiny figure and the present health and safety regulations and working practices that must be adhered to when dealing with asbestos or where there is the slightest suspicion that asbestos may be involved? (89.1) The only regulations that match these strict working practices are workers dealing with irradiated material in nuclear power stations or deadly infectious diseases such as Ebolavirus and the like! The extent of the asbestos hazard is indeed known, but not fully admitted.
We know that there is no safe level of exposure to asbestos. We know that workers in shipyards in the west of Scotland were exposed to massive amounts of asbestos. We know that these workers have suffered massive amounts of lung cancer deaths; more than anywhere in the UK, yet only 5.7% is down to asbestos? Does anyone really believe that!
A clue as to how the study came up with the absurd 5.7% figure is that the study deems smoking to be a major confounder which was determined from the incidence of chronic bronchitis. Is this a ‘strong correlate’? Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks. Chronic bronchitis is not necessarily caused by infection and is generally part of a syndrome called chronic obstructive pulmonary disease (COPD). Have a look at some official views on this;
HSE government statistics (2007) state; “The multi-factorial nature of COPD and the fact that cases resulting from different causes are clinically indistinguishable means that it is difficult to determine how many cases may be due to occupational exposures”.(90)
According to Miravitlles et al (PubMed 2007),“Bacteria are isolated in more than 50% of exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD) (91)
A Korean 4 year study even found a relationship between snoring and Chronic Bronchitis that included smokers and non-smokers. (PubMed 2008) ‘CONCLUSIONS: This prospective study observed that snoring is associated with chronic bronchitis. Our findings provide support for the hypothesis that snoring influences the development of chronic bronchitis.’ (No joke! - a 4 year study on snoring !) (92)
So, here again, a basic correlation between chronic bronchitis and smoking is suggested, but again it is not exclusively linked to smokers. Pi is not 3.142! Is it therefore a good way of determining a cause of smoking and lung cancer and then excluding those from the study? Would it be trite of me to suggest that this study, carried out in the highest lung cancer region in the UK, was not to determine the amount of lung cancer caused by asbestos at all, but to ‘prove’ it to be less culpable than smoking?
The illustration below is meant to compare the risks of second hand smoke with other everyday risks, but look at the almost identical risk factors of; Asbestosis (9.0) ..and.. Smoking (10.0).
Now compare those risk factors with these estimates of lung cancer deaths;
Each year in the UK, more than 34,000 people die from lung cancer.
Smoking causes almost 90% of lung cancer deaths.(thats over 30,000) (CRUK)
Asbestosis is non-malignant scarring of lungs. "It is likely that there are around as many asbestos related lung cancer deaths in Great Britain annually as there are mesothelioma deaths. There were 2056 mesothelioma deaths in 2006" (HSE) (51)
Who cannot see a clear and massive mis-match here:–
30,000 deaths from smoking, with a Relative Risk of 10.0, - 900% increased risk.
4,112 deaths ? from asbestos, with a Relative Risk of 9.00, - 800% increased risk.
Most asbestos lung cancers are NOT diagnosed ... lung cancers previously attributed to smoking
may in fact have been caused by asbestos; (Dr Douglas Henderson, Director of pathology, Flinders University) (39)
Corroborative studies ?
So, we now have hundreds maybe even thousands of studies based on Dolls methodology that circumstantially ‘prove’ a correlation between smoking and lung cancer, with the more recent increasingly likely to be tainted by vested interest, but have these been replicated in other studies using different methodologies? The simple answer in NO!
The scientists will quote various corroborative studies that include retrospective studies (where questionnaires are used that are based on subjects memories from the past (eg. how many cigarettes have you smoked or been exposed to 40 or 50 years ago?). Prospective studies / cohort studies (where subjects are studied over time) and meta analysis which is basically a study of studies, using the results from a number of studies to ascertain an overall picture. Of course, all of these studies are just variations on Dolls original studies and have the same disadvantages and flaws. In the case of meta-analysis, in addition to the basic disadvantages, an additional problem is one of ‘cherry picking’ the studies that conform to the authors original hypothesis, and omitting the ones that don’t, usually by claiming that they were methodologically flawed. In reality, as far as I and some others are concerned, this whole branch of ‘science’ is itself terminally flawed.
The obvious alternative method to prove causation is by animal experimentation and this has been tackled with fervour by anti-tobacco, but with no more success. One experiment claiming ‘proof’ of the carcinogenic nature of ‘smoking’, is as close as they have gone but consisted, not of smoking, but of painting tar on the backs of rats which produced tumors in just over half of them – nearly half did not have adverse effects. Anti-tobacco has been frantic to provide ‘hard evidence’ for decades but has consistently failed. Lauren Colby outlines a number of these experiments that have used various methods to induce lung cancer in animals (94). Experiments using such as rats (specifically bred to be prone to cancer) and corgi dogs have consistently been unable to produce any positive statistically significant results although, as with the former studies, scientists still claim some success.
Jonathan Balcombe, PhD from the Physicians Committee for Responsible Medicine (PCRM), on the subject of animal experimentation states; “Scientists like to joke that smoking is a leading cause of statistics. It's an amusing observation, but sadly, when it comes to animal experimentation, it’s all too true. Despite the failure of numerous animal studies during the 1950s and 1960s to reveal a clear link between cigarette smoking and cancer—and despite our established knowledge from human clinical data that smoking is deadly—smoking experiments on animals continue”. (95) (‘established knowledge’ is no doubt, those studies that I referred to earlier (Pi= 4.142)). He then lists various animal studies carried out during 2004, (remember the demise of scientific study) some of which do claim a link between smoking and cancer or a synergistic effect of smoking and asbestos but I have been unable to access these studies. However, He concludes “Many of these experiments appear to be useless attempts to confirm what is already known in humans”. (is that the case – or – could it be that Balcombe has missed the point that the elusive corroborative evidence is not ‘useless’ from the point of view of many scientists but, knowing the limitations of epidemiological study, is essential’. Yet they have consistently failed?)
Other studies have tended only to indicate that tobacco smoke had beneficial effects;
An experimental study by A.P. Wehrner, et al, (1981) produced results showing that the highest number of tumors occurred in the untreated control [non-smoking] rats. The next highest number of tumors occurred in rats subject to sham smoking, i.e. rats which were placed in the smoking machine without smoke exposure, and the lowest number of tumors occurred in the smoke-exposed rats.”
“At a U.S. congressional hearing in 1982 Dr. A. Furst, director emeritus, Institute of Chemical Biology, University of San Francisco, gave sworn testimony that he had tried for many years to induce lung cancer in animals with cigarette smoke but without success. He also testified that every other investigator who had attempted this had also failed. This was confirmed by the testimony of scientists Schrauzer, Macdonald, Hockey, Buhle and Hackett, showing quite clearly that no animal has ever got lung cancer from inhaling cigarette smoke.” (Whitby WT 1986 p6)
“Coggins (1998, 2001, 2002) reviewed several chronic inhalation studies using rodents, dogs, and nonhuman primates, and concluded that no study has produced a statistically significant increase in lung tumors” (Oxford Journal 2004)
Many animal experiments have attempted to link lung cancer with the synergistic affects of smoking or passive smoking and asbestos. In effect acknowledging that there are many unexplained cases of lung cancer but refusing to accept that asbestos is capable of explaining those and attempting to maintain the smoking/SHS link by trying to prove a synergistic relationship- that asbestos is really only dangerous if the subjects are also exposed to SHS or in conjunction with smoking. “We know that if a person gets a particle of asbestos in his lung tissue he will most likely get a lung cancer. How can it matter if he smokes or not? He will get the lung cancer just the same.” (Dr W Whitby 1986) (96)
The US DHH, National Institute for Occupational Safety and Health (NIOSH)(1980), gives the following information; “All commercial forms of asbestos are carcinogenic in rats, producing lung carcinomas and Mesothelioma following their inhalation.... Mesothelioma and lung cancers were induced following even 1 day’s exposure by inhalation. The size and shape of the fibers are important factors, fibers less than 0.5um in diameter are most active in producing tumors” (that’s pretty small and very relevant when considering airborne wind - spread). “There are data that show that the lower the exposure, the lower the risk of developing cancer.” “Evaluation of all human data provides no evidence for a threshold or a ‘safe’ level of asbestos exposure’ (97) (Note that this information was available in 1980!)
So, smoking has been very difficult or has failed altogether to induce lung cancer in animals but it has been very easy to induce on exposure to asbestos! – The corroborative evidence is clear and unambiguous for asbestos but not so for smoking.
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Downplaying, Subterfuge and Asbestos Secrets
Any death that is associated with asbestos, generally considered to be an industrial disease, has to be investigated. It is one of only a few diseases where the coroner must be notified and he must investigate. This usually involves a post mortem, research into occupation, exposure, medical history etc. This is a very bureaucratic, time consuming procedure usually involving the certifying doctor, the family doctor, the police coroners officer, the coroner and others if relevant, to determine causation and culpability or liability of employer etc. Doctors will {only} accept that lung cancer has been caused by asbestos exposure if it can be shown that the person suffering from lung cancer already has asbestosis or has been exposed to enough asbestos dust to cause asbestosis. (98) (Why? – back to Dolls Pi=4.142?) A long drawn out legal process then takes place to determine what, if any, compensation the sufferer is entitled. If the lung cancer is not considered to be an industrial disease then none of this is required. Is it any surprise that most asbestos related disease is misdiagnosed and mortality incorrectly recorded, bearing in mind the general views on the dangers of smoking and the ease in which it can be used as a ‘most likely’ lung cancer cause? It is in no ones interest other than the sufferer to suggest asbestos as the culprit. A doctor for instance would have far more to lose should his competency be successfully challenged by some slick industry solicitor, (but imagine what would happen if doctors were given a substantial share of any compensation claims regarding asbestos!) Known asbestos victims have been treated despicably.
Below is a table that shows deaths registered 2003-2006 and the numbers certified by a doctor or a coroner.
National Statistics; All Deaths registered in 2006
Table E Deaths by method of certification and registration, 2003–06
2003 2004 2005 2006
Number % number % number % number %
Total deaths 539,151 100 514,250 100 512,993 100 502,599 100
Certified by doctor: 421,319 78.1 399,436 77.7 398,825 77.7 391,638 77.9
With coroner not involved, 353,286 65.5 329,648 64.1 323,780 63.1 314,365 62.5
without post-mortem 351,140 65.1 327,850 63.8 322,016 62.8 312,632 62.2
with post-mortem 2,146 0.4 1,798 0.3 1,764 0.3 1,733 0.3
After referral to coroner,
registered with no
post-mortem or inquest 68,033 12.6 69,788 13.6 75,045 14.6 77,346 15.4
Certified by coroner: 117,029 21.7 113,944 22.2 113,202 22.1 109,911 21.9
Coroner’s post-mortem
held, with no inquest 92,332 17.1 88,041 17.1 86,424 16.8 82,595 16.4
Coroner’s inquest
completed, with or 23,598 4.4 24,768 4.8 25,667 5.0 26,268 5.2
without post-mortem
Coroner’s inquest adjourned 1,099 0.2 1,135 0.2 1,111 0.2 1,048 0.2
Uncertified 803 0.1 870 0.2 966 0.2 1,050 0.2
This illustrates how few cases of asbestos related mortality have been investigated. Only 110,000 of the 500,000 total deaths in 2006 involved the coroner, even less have involved a post mortem to determine cause of death. Only a fraction of that 110,000 will have been treated as asbestos related, as the coroner deals with all cases of ‘sudden death’ eg fatal road accidents, industrial accidents, suspicious deaths, etc.
Misdiagnosis is more common than generally considered to be the case; Heasman and Lipworth surveyed reports from 75 hospitals of the National Health Service in England and Wales, comparing the doctors' diagnoses made in the patients' lifetimes with the result of postmortem examinations. For cancer of the lung, they found that doctors had diagnosed 338 cases when the pathologists had found 417; in only 227 cases did the doctors and the pathologists agree. In fact 33% of cases diagnosed as lung cancer were wrongly diagnosed, and 46% that were supposed to be something else were actually lung cancer.
Another study by Feinstein and Wells (Trans. Assoc. American Physicians 87) found that heavy smokers have a 90% chance of getting their lung cancer diagnosed (not necessarily correctly, of course), while non-smokers had a 62% chance.(99), indicating an inherent, probably subconscious, bias.
It is now known that 174.470 Americans were diagnosed with lung cancer in 2006. That is the highest number ever.” Never before have so many Americans been diagnosed with lung cancer. Never before in modern history have Americans smoked so few cigarettes”. Compare this with 1950 when 20.000 Americans succumbed to lung cancer. (100) Can all these new Lung cancers really be caused by smoking? Bearing in mind the bureaucratic procedures and strict criteria in diagnosis of asbestos related disease together with the general difficulty and unwillingness in determining asbestos as a cause of lung diseases, compare these US lung cancers statistics with this UK asbestos related graph. The disablement benefit trend may be relevant even though the figures are almost certainly unrepresentative;
While smoking/lung cancer studies have been often exaggerated and promoted with dynamism, asbestos/lung cancer studies have typically been downplayed or suppressed, some even today will not be released for public view. Many early studies have simply been 'lost' or locked away and the key discarded. For example; BMJ – “The hazards of asbestos. Access to vital data is denied”..(102). Or; “Documents from the 1930s and 1940s reveal that many asbestos manufacturers were aware of the serious health issues surrounding asbestos, but kept the information secret from workers and from the public” (‘Asbestos; think again’ USA) (103)
‘Either in 1942 or 1943, the president of Johns-Manville, Lewis H. Brown, said that the managers of another asbestos company were "a bunch of fools for notifying employees who had asbestosis." When one of the managers asked, "do you mean to tell me you would let them work until they dropped dead?" the response is reported to have been, "Yes. We save a lot of money that way."(104)’ (Wikipedia) - (Testimony of Charles H. Roemer, Deposition taken April 25, 1984, Johns-Manville Corp., et al v. the United States of America, U.S. Claims Court Civ. No. 465-83C, cited in Barry I. Castleman, Asbestos: Medical and Legal Aspects, 4th edition, Aspen Law and Business, Englewood Cliffs, NJ 1996, p.581) (note-This seems unlikely to me - but- there is no accounting for human nature!)
Then we have in 1957, the creation of the The Asbestosis Research Council (ARC). On the surface, the Council was set up in response to the continuing escalation of the incidence of asbestosis in the UK, to “foster research into the causation and prevention of asbestosis and any other diseases possibly associated with exposure to asbestos “. Members and sponsors of this council provide an indication as to the real purpose of its inception; British Belting and Asbestos, Cape Industries and Turner and Newall. "Strategy was set by the management committee, which in turn responded to the wishes of the sponsoring directors. "these men did not see the ARC as fundamentally a council for scientific research. Ultimately, it was an attempt to capture the scientific agenda and influence public policy." The name of the ARC was well chosen; the combination of words sounds quasi-official and reassuringly medical. The impression created of independent, benevolent concern was manipulated by industry to great effect. While statements by asbestos manufacturers would have been disbelieved, information disseminated by the ARC and later the Asbestos Information Centre was readily digested (105)
Numerous scientists have tried to find a reason why never-smokers get lung cancer and that has usually taken the form of linking the synergistic effects of smoking or ETS with asbestos It is alleged that smokers exposed to asbestos are ten times more likely to get lung cancer than non smokers, could that be because historically there were very few non smokers amongst those who worked with asbestos? (see also ‘Downplaying, Subterfuge and Asbestos Secrets’ above). Unfortunately for anti-tobacco, there are studies that show smoking to lower the risk of asbestos lung cancer.
"Effect of Smoking on Immunological Abnormalities in Asbestos Workers" (Institute of Immunology and Experimental Therapy, Poland) by Lange, A.: “Smoking has a protective effect on immunological abnormalities in asbestos workers.” "Cancer of the Lung among Asbestos Factory Workers" (University of London, School of Hygiene and Tropical Medicine), relative risk of lung cancer for asbestos workers was "highest for those who had never smoked, lowest for current smokers, and intermediate for ex-smokers. The trend was statistically significant. There was no significant association between smoking and deaths from mesothelioma," (106) (this link also shows other benefits of smoking too) or;
Berry and Liddell (2004); Conclusion: The excess relative risk of lung cancer from asbestos exposure is about three times higher in non-smokers than in smokers. The modified measure has been placed within a more versatile model of interaction. If interaction is present the relative risk from asbestos exposure changes only slightly between light and heavy smokers, but is higher in very light smokers and non-smokers. (107)
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Other Research, Unexplained Anomalies, and Inconvenient Truths
Whilst the comments above mainly concentrate on smoking, asbestos and epidemiology, I am not suggesting that the lung cancer debate is limited only to these factors, neither am I suggesting that smoking is entirely innocent. I am saying that its culpability has been exaggerated way beyond any possible sense of proportion. It will, without doubt, get much worse before common sense prevails. Since the recent devaluation of ‘smoking’ science by providing almost unlimited funding to any scientist who is prepared to produce the ‘right results’ while squashing genuine, impartial study, there has been a rush to produce as much junk science as possible. ‘Scientific study’ relating to medical matters has today been reduced to either a political ‘spin’ tool or sales literature for the pharmaceutical industry!
Cancers have been linked to many substances, bacteria and genetic factors etc. but some factors are seen as more culpable than others. The present ‘agreed consensus’ is that smoking is the primary factor, but many others argue that this is wrong. Asbestos is also considered to be one of the primary causes but its culpability has consistently been trivialized, despite copious amounts of evidence to the contrary. Asbestos allegedly causes cancers other than lung and so do many other substances, but smoking always seems to take centre stage and has some adverse effect, overriding other causes according to anti-tobacco sources. Smoking trumps anything else when it comes to health hazards. As examples, everything from bad teeth to droopy willies are alleged smoking problems, yet smoking (nicotine) improves vascularization, improving blood flow and there are higher serum levels of total testosterone in smokers (108). Studies have also shown that non-smokers tend to have the most problems with teeth. (109) ‘Anti-tobacco’ still states that smoking causes cervical cancer, yet it has been known for several years that the main cause is the Human Papillomavirus (HPV). An effective vaccine was developed for HPV in 2006 and is now widely dispensed. Other untainted study is beginning to show that HPV is also associated with lung cancer (110)
Professor Eysenck in his paper – “How many people does smoking actually kill?”, points to anomalies in anti-smoking data such as the 1989-90 Australian Bureau of Statistics National Health Survey which showed that smokers were the healthiest group, followed by non-smokers, and ‘a long way behind’, ex-smokers.( Castles, I. 1989-90) (111)
James P. Siepmann, MD, argues in his article that if you look at the information that claims smoking causes harm from official sources, they actually show that “Smoking Does Not Cause Lung Cancer (According to WHO/CDA Data)” (1999) (112)
Dr William T Whitby In his book, ‘The smoking scare de-bunked’ quotes a number of anomalies that fly in the face of anti-tobacco rhetoric; eg. "Dr. C.Y .Caldwell wrote in the British Medical Journal of February 26th 1977 that the Semai people of Malaysia start smoking at the age of two when they give up breast feeding. It is a sort of weaning. Then they continue to smoke all their lives - and they don't get lung cancer!" Whitby in fact identified the erroneous nature of the anti-smoking campaign in the early 1980’s. “It is the Big Lie of the twentieth century and I feel I can easily show this to the intelligent and unbiased reader” (113) Here we are over twenty years later and the anti-smoking religion has more followers than ever – where are these intelligent, unbiased readers? Is religion and ‘belief’ stronger than truth ........ or has the anti-smoking, healthist religion usurped science?
It was identified very early that lung cancer is far more prevalent in urban environments compared to rural ones but we also know that it is also much worse in countries with industrial economies compared with rural economies or in developed compared with developing countries. As with many anomalies, these differences have never been adequately explained by anti-smoking commentators! It is common for populations in rural economies to smoke the same or more than those in developed countries yet invariably suffer less lung cancers. (114) eg;
Excerpt from; Global lung cancer incidence and mortality rates, 2000
(Deaths per 100,000 population) (87)
Deaths Male Female
More developed countries 50.15 13.14
Less developed countries 22.02 7.40
Eg.
Western Europe 48.94 9.18
Western Africa 1.98 0.31
South-central Asia 10.86 2.15
Age-standardized rate.
Source: GLOBOCAN 2000. Cancer incidence, mortality and prevalence worldwide. version 1.o I. pg9
Anti-tobacco claim that developed countries can expect less lung cancer because of better tobacco control and that the ‘increase’ in smoking in third world countries will mean their population will have more lung cancers in the future. What they fail to point out is that many third world countries do not have the same asbestos restrictions as the developed world and asbestos use may be increasing! “Some developing countries, such as India and China, have continued widespread use of asbestos. The most common is corrugated asbestos-cement sheets or "A/C Sheets" for roofing and for side walls. “Millions of homes, factories, schools or sheds and shelters continue to use asbestos.” (115). Asbestos brake and clutch lining are still produced (116) (117)
Why are efforts to educate developing countries on public health apparently limited to tobacco control and NOT asbestos? Why are they diverting attention away from asbestos again, and risking the massive death toll that the developed world has already suffered? For what; to protect those who have perpetuated the lie of ‘smoke related disease’ in the developed world? So that their; ‘Stages of the world tobacco epidemic’ graph is not proved wrong? It beggars belief!
One of the most inconvenient truths is that there are many benefits that come with smoking. I will not list them all here as there are plenty of sources which provide that information. One example is that smoking substantially reduces the risk and delays the onset of Alzheimer’s disease. In the US, with the Baby Boom generation getting older, it is estimated that care for Alzheimer's patients will cost the country ONE TRILLION, TWO HUNDRED BILLION dollars. “If the onset of Alzheimer's could be put off five years the amount of money would be cut in half!” (American Solutions Conference, Sept 2008; Newt Gingrich) (Jeremy Richards, PhD). The cost, for this one disease alone, dwarfs the (estimated) inflated costs of all, so called ‘smoking related diseases’!
The list goes on and on regarding these inconvenient truths, but the scandal is that the scientific community are so predisposed to furthering the smoking deception that real research into real causes of cancer have been demoted to ‘also rans’ and have not been given anywhere near the attention or resources they should. Dr Samuel Epstein has long argued this and points to the massive increase in all cancers in his paper ‘The Stop cancer before it starts campaign’,2003 (118), Despite his long held views on smoking, he argues that the only reduction in cancers are male lung cancers and attributes this to the reduction in smoking. He comments; “Since 1971, the overall incidence of [all] cancer in the U.S. alone, has escalated to epidemic proportions, now striking about 1.3 million and killing about 550,000 annually; nearly one in two men and more than one in three women now develop cancer in their lifetimes”. He goes on to point out that; “National cancer policies are now threatened more than ever before by the indifference of the cancer establishment to primary prevention, and its silence on avoidable causes of cancer, other than personal lifestyle. As seriously, this silence reflects denial of citizens' democratic Right-to-Know and empowerment, and rejection of environmental justice, by sacrificing citizens’ health and welfare to powerful corporate interests.”
It turns out that Epstein is mistaken in relation to his ’reduction’ in lung cancers, noting the massive increase in lung cancers recorded in the US by 2006 as pointed out earlier. Also, while unadulterated mortality/morbidity figures are hard to come by, I did find two publications by the American Cancer Society (Cancer.org) that contained US cancer statistics for 2000 and 2008 (appendix 1and 2). They show that almost all cancer prevalence, with the apparent exception of cervical and breast cancers, have increased quite dramatically;
These increases in US cancers are not insubstantial, in fact, nearly an 18% increase in all cancers and nearly a full one third increase in lung cancer in the space of a mere 8 years, may be very revealing but, quite frankly, shocking! Is this where other lifestyle choices move into the equation? As Lung cancers and other so called 'smoke related' diseases stubbornly refuse to decline in line with smoking reduction then alcohol consumption, obesity etc can be blamed for that 'anomaly'?
It turns out that Epstein is mistaken in relation to his ’reduction’ in lung cancers, noting the massive increase in lung cancers recorded in the US by 2006 as pointed out earlier. Also, while unadulterated mortality/morbidity figures are hard to come by, I did find two publications by the American Cancer Society (Cancer.org) that contained US cancer statistics for 2000 and 2008 (appendix 1and 2). They show that almost all cancer prevalence, with the apparent exception of cervical and breast cancers, have increased quite dramatically;
US all cancers, new cases:
2000, 1,220,100
2008, 1,437,180 (17.78% increase)
US Lung and Bronchus cancers, New Cases:
2000, 164,100
2008, 215,020 (31.03% increase)
These figures should be considered while bearing in mind that smoking prevalence has reduced by around 50% from its peak in the late 1940's, that 'US life expectancy from birth' has consistently and steadily increased, regardless of the level smoking incidence (eg.1890; 42 years / 2005; 77 years), and that the US population has increased by only 8% between 2000 and 2008.
2000:- 281,424,602
2008:- 304,059,724 (8% increase)
One last comparison I would like to make between smoking and asbestos is that analysts have estimated that the total costs of asbestos litigation in the USA alone is over $250 billion. (115). Ironically, although this cost is likely to increase even more, it is almost the exact figure that was awarded against tobacco companies in the US Master settlement agreement. Asbestos litigation is the longest, most expensive mass tort in U.S. history, involving more than 8,400 defendants and 730,000 claimants as of 2002 according to the RAND Corporation and at least one defendant reported claim counts in excess of 800,000 in 2006. It seems that while many scientists, doctors and all ‘anti tobacco’ organisations continue to blame almost every adverse health effect on smoking, the legal profession are looking further. Isn’t it time others did the same?
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The Debate is Over! – Is it ?
The ‘Debate is over’ is a commonly used expression coined by anti-tobacco commentators, when referring to smoking research and this is generally believed by most of the public, a testament to the power of propaganda. Anyone who so much as hints that smoking may not be the monster it is portrayed to be will be labeled as ‘deluded’, or ‘in denial’, “everyone knows the dangers of smoking!” This type of claim to finality is nothing new. The debate was ‘over’ on the subject of order within the universe as definitively outlined by Sir Isaac Newton in the 17th century – until Albert Einstein reopened that debate and, in his theory of relativity over 200 years later, proved that Newton’s theory was flawed.
The debate has only ‘been over’ for about a half century in relation to smoking and health. Those lies and misinformation so blatantly expressed in relation to SHS have led to more people looking to the truth and integrity of the science and scientists who ‘proved’ that primary smoking was the cause of the 20th century cancer epidemic. Primary smoking and its relationship to health is now back on the agenda as more people gain the knowledge to challenge long held flawed views, illusions and deceptions!
Newton’s flawed views on the universe caused no one any harm – that is where the comparison ends. The ‘new finality’ on smoking and health, together with the rise and empowerment of anti-tobacco fanatics, have caused much irreparable damage to social cohesion, incurred substantial moral, social and financial costs, tarnished medical and scientific integrity, empowered the intolerant, the bigot and the fanatical puritan, but above all it has fostered a cavalier attitude towards personal and social freedoms, freedoms that have been hard won over many years by our forebears, freedoms that should never ever be surrendered lightly!
Despite their overwhelming success in diverting attention away from their crimes against humanity, onto individual lifestyle choices, asbestos companies are all but extinct, bankrupted and now only a shameful disaster confined to history. While their legacy lives on today, the real present and future threat to mankind is now in the hands of Big Pharma, the main driving force behind the anti-smoking movement! (119)
This document will never convince all readers on the relative culpability of smoking and other lifestyle choices, compared with asbestos and other industrial contaminants, but I hope it motivates the open minded to look deeper than may otherwise be the case. What I will say is that the debate, as far as I am concerned, needs to look more closely at the smoking/asbestos deception to identify those responsible for knowingly perpetuating it. Not all involved in the deception are culpable; many, even professionals, are only guilty of gullibility and allowing themselves to be unquestionably led by the nose ring within the boundaries of a propaganda campaign that has its roots in Nazi Germany. A new debate needs to begin as to how we deal with those who have maliciously suppressed genuine research, produced false or misrepresented evidence, sold their soul for 30 pieces of silver, or to get their 15 minutes of fame! .... I will not hold my breath in anticipation! Corporate money and interests have always trumped genuine science and probably always will, unless good men do something! ......
“The only thing necessary for the triumph of evil is for good men to do nothing! (Edmund Burke)
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Appendix 2
ACS (Cancer.org) Estimated New Cancer Cases United States 2000
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Note that these appendices are direct screen prints of pages from the ACS website, Cancer.org. They were copied before these on-line pages were moved/deleted. I am sure that it is purely coincidental that the ACS is strongly anti-tobacco or that they disappeared shortly after being used as references in on-line discussions. The original addresses, for what they are worth, are copied below.
Appendix 2
ACS (Cancer.org) Estimated New Cancer Cases United States 2008
ACS (Cancer.org) Estimated New Cancer Cases United States 2008
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March 2009
Personal note: I am not associated in any way (other than as a consumer) with any industry including the Tobacco Industry or the Pharmaceutical industry. I also point out that I am neither part of the scientific nor medical community and claim no special qualifications in those areas. The association between asbestos and lung cancer is clear to anyone with an open mind. Nothing in this document should be taken as either medical or legal advice, but instead should act as a resource in providing general information that may be useful to the general public, and a basis for further research. My comments are motivated by my realization of the escalating crisis of integrity and impartiality in those scientific and medical communities, together with the increasing invasion, by government, into personal lifestyle choices and control of individual freedoms. These are symptoms of a move towards modern day fascism and an invasive cancer that is now spreading throughout the world. Most of the information I provide above is what anyone can access and find by research on the internet. I hope that I inspire others to do just that as I am sure that there is much more to this scandal than I have discovered.
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2009 (updated July 2010) Kin_Free
